Hi, I'm Carrie Blum. I'm a primary care doctor.

And I'm Greg Katz. I'm a cardiologist and also like to think of myself as an internist.

And welcome to mind the gap on A1C and measurements of glucose control.

Today we're going to briefly dive into the history of glucose measurements and how we came to use the Hemoglobin A1C and will also

impact some of its limitations. And then we'll talk about some of the newer kids on the block, from Toseamine, like

oscillated albutin and continuous glucose monitors.

And lastly, we'll get into a little bit about the big picture, about what glucose measurement does and does not

toss. If you were to walk through before Hemoglobin A1C, what were the original

mechanisms of deciding does this patient have diabetes or does this

patient not have diabetes? So in order to diagnose diabetes it became clear that

what we really needed to do was measure glucose But the problem with that is that glucose

fluctuates a lot. So there's really three options you have. You can do a

random glucose, you can do a fasting glucose, or you can do a glucose tolerance

test. The problem with random glucose is that you need to do it a lot in

order to get a sense of how high and how low it gets around mealtime. Fast

in glucose of course is helpful but you only see half the picture so you're not going to see how much

hyperglycemia is in the post-prandial state.

And a glucose tolerance test can be very tedious because it involves having multiple blood tests over many hours,

but it does provide good information in both a fasting and a postprandial glucose measurement.

I would also argue that the fasting glucose, particularly glucose

particularly will miss a fair amount of patients because that's like the last thing that becomes

abnormal, right?

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